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.Tl1-8-2005 15:14 FROM: T0:14252r78857 P.2 <br /> � <br /> PERMiT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 425-257•8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO 1 PM -DE81T 6 CREDIT CARDS ARr NOT ACCEPTED <br /> SrtE ADDRESS PMCEL TAX I.D.�► PERMIT N <br /> 1 b3 i Ru�f� cx� � a s� � - <br /> IEGA LOTNO. BLOqC 7RACT <br /> DESC. <br /> ADDRE..B <br /> Q�iibqr� C�n.ou��ec�x to�i �k�rr�� �i���a' 339ofi� <br /> TEtlANTNAME CONTAc�FO�RPER�MR 7HONE <br /> �°r /LC-f� I �-�1Y[L �l-.1`7 �0 3Z�d°' <br /> CON TO � ADDRESS L� PMONE �� <br /> '��v�9'JiY �' ar��/�c���� <br /> corme.ueEHsc� �` <br /> Lufi✓/lY�,l�7/a8 2�1-f�7�u <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> J, '� Electrlc �Ges ONer � �� <br /> WORK DESCRIPTION <br /> G� � l��J C!/u�' /1L47� �'�'�rr�`V <br /> l <br /> PLUMBIN(i MECHANICAI. <br /> NO. TYPE OF FI%TVRE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C-alr hendling units <br /> Bathtub ForceG alr syslems <br /> Lavalory(wash basin) Gas piping <br /> _ Shower � Waterhealer <br /> Kitchen sink R disposal Gas fireptace <br /> DisMuesher Gac range <br /> Cbthea washer CbNes dryer <br /> LaunOry troy Renge hood <br /> Sink(servicelberlmop/etc.) E�auct fan <br /> Backlbw preventer Heat pump <br /> Udnat Unh heater <br /> Drinking Founlaln _ Boikr <br /> Floor drain Refrlgeratlon <br /> Greaae trep Woodstove <br /> Roo(droins Other <br /> Other <br /> CITY OF EVERETf LOCAL SALES TA7(GODE IS]10S <br /> I hereby cerlUfy that I have read and ezamined this applkatlon and kraw the seme to be We and cortect. All p�ovisions of lews and <br /> ordinacee governinp this type ot work wlll be wmplbd wilh whaBier specified herain or rrot.The grantinp ol a partnit does rrol presume <br /> to give authority to violale or cancal 1he provislon of eny other stete or bcal�aw regulatlng consWdion or the perlormance ot <br /> conslnution.That I am authorized by the owner of this propeAy ta partoim the work for which applkatlon is made and I compy wltl�fhe <br /> State Conhaclors Le .27 RCW and 296.2 0 WAC. <br /> $ al o w�dCon rector Auth Agent ���� " <br />